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Objective:To observe the clinical efficacy of combining repeated transcranial magnetic stimulation (rTMS) with radiofrequency ablation (RF) of dorsal root ganglia in treating herpes zoster infection and neuralgia.Methods:Eighty-four individuals with a herpes zoster infection who had suffered from neuralgia for no more than 7 days were divided randomly into a control group, an rTMS group, an RF group, and an observation group, each of 21. All were treated with gabapentin, valciclovir and mecobalamin. The rTMS group received rTMS treatment, 5 days per week, for 2 consecutive weeks. The RF group received RF treatment of the dorsal root ganglia on the 15th day after enrollment, while the observation group received only the medication. Before the experiment as well as after 3, 7, 16, 30 and 60 days, all of the subjects self-assessed their discomfort using a pain visual analog scale (VAS). The Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), Quality of Life Assessment Scale (QOL-SF36), and Pittsburgh Sleep Quality Index (PSQI) were also administered.Results:The average VAS, HAMA, HAMD, QOL-SF36, and PSQI scores of the observation group improved continuously and significantly during and after the treatment. Beyond 16 days all of those results were significantly better than the control group′s averages, and the observation group′s average VAS, HAMA and HAMD results were also significantly better than those of the rTMS group. The observation group′s average VAS, HAMA, HAMD and PSQI scores had improved significantly more than the RF group′s averages beyond 30 days.Conclusion:Combining rTMS and dorsal root ganglion RF can effectively alleviate the early pain symptoms of herpes zoster infection and neuralgia, relieve anxiety and depression, and significantly improve sleep and life quality. Such therapy is worthy of clinical promotion and application.
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Objective:To evaluate the efficacy and safety of endoscopic papillectomy (EP) combined with endobiliary radio frequency ablation (RFA) for duodenal papilla tumor with intraductal biliary infiltration.Methods:Data of 12 patients with histologically confirmed duodenal papilla tumor combined with intraductal biliary infiltration treated by EP with RFA from February 2013 to February 2019 were retrospectively analyzed. Clinical characteristics,endoscopic features, treatment efficacy and postoperative complications of patients were reviewed and recurrence was followed up.Results:The median diameter of lesions measured by endoscopic ultrasound was 18.5 mm×15.5 mm, and the length of intrabiliary invasion was 14.1±5.8 mm. EP combined with RFA was successfully performed in all patients with a technical success rate of 100%. Postoperative pathology showed adenocarcinoma in 5 patients, adenoma with high-grade intraepithelial neoplasia in 6 patients, and adenoma with low-grade intraepithelial neoplasia in 1 patient. Patients received mean 4.1±1.6 times of ERCP with intraductal biopsy during a mean follow-up period of 28.5±10.4 months. Recurrence occurred in 2 patients at 14 and 20 months respectively, both were adenocarcinoma.Conclusion:EP combined with RFA is effective and safe for duodenal papilla tumor with intraductal biliary infiltration. However, given the risk of recurrence, close surveillance is recommended.
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Wolff-Parkinson-White (WPW) syndrome is not a common presentation, but physicians get to see cases with pre-excitation syndrome. WPW is characterized by the existence of an accessory pathway that predisposes patients to tachyarrhythmias and sudden death. Patients with WPW syndrome are at greater risk of hazardous ventricular arrhythmias. The majority of the cases never present with an underlying structural cardiac disease. It is always controversial to manage asymptomatic patients with WPW syndrome. Here, we discuss an uncommon case of a 48-year-old man with WPW syndrome after being evaluated for palpitation and giddiness.
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The treatment modality of recurrent hepatocellular carcinoma(HCC) includes surgical resection, liver transplantation, ablation, interventional therapy, targeted therapy,and systemic chemotherapy. However,the complexity of disease condition often leads to unsatisfying outcome by single treatment, making multidisciplinary treatment an inevitable choice. Commonly used combined therapies are transarterial chemoembolization(TACE) combined with surgical resection,TACE combined with local ablation,and TACE combined with systemic treatment. In clinical practice,the goal of comprehensive treatment is prolonged survival and improved quality of life. Choosing different combination of therapies according to different liver function,general condition and recurrence of tumors can significantly improve the patients' survival.
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Objective To observe the clinical efficacy and safety of transhepatic arterial chemoemboli-zation (TACE)combined with radiofrequency ablation (RFA)in the treatment of colorectal cancer with liver metastasis. Methods The data of 92 patients with colorectal cancer with liver metastasis admitted to Nanyang First People's Hospital of Henan Province from January 2014 to January 2016 were retrospectively analyzed. A total of 46 patients treated with TACE were selected as the TACE group,and another 46 patients treated with TACE and RFA were selected as the combined group. The clinical efficacies of the two groups were compared, and the changes of Karnofsky functional status (KPS)scores before and after treatment in the two groups were analyzed. The incidences of complications in the two groups were calculated. Patients in the two groups were followed up,and the progress-free survival (PFS)and overall survival (OS)were calculated. Results The disease control rate of the combined group was 82. 61％ (38 / 46),and that of the TACE group was 63. 04％(29 / 46). The disease control rate of the combined group was higher than that of the TACE group (χ2 = 4. 449, P = 0. 035). Before treatment,the KPS scores of the combined group and the TACE group were 71. 84 ± 4. 37, 72. 22 ± 4. 26,with no statistically significant difference (t = 0. 423,P = 0. 673). After treatment,the KPS scores of the two groups were higher than those before treatment,and the KPS score of the combined group was higher than that of the TACE group (79. 81 ± 6. 15 vs. 75. 86 ± 6. 02;t = 3. 108,P = 0. 003). The incidence of complications was 54. 35％ (25 / 46)in the combined group and 41. 30％ (19 / 46)in the TACE group. The difference between the two groups was not statistically significant (χ2 = 1. 568,P = 0. 210). The median PFS and OS in the TACE group were 12. 6 and 20. 7 months,and those in the combined group were 18. 9 and 28. 2 months. The PFS and OS of the combined group were longer than those of the TACE group (χ2 = 72. 025, P < 0. 001;χ2 = 26. 580,P < 0. 001). Conclusion TACE combined with RFA is effective in the treatment of liver metastasis of colorectal cancer,which can effectively improve the KPS score of patients,prolong the PFS and OS,and do not increase the risk of complications.
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Objective@#To evaluate the efficacy and feasibility of radiofrequency ablation(RFA) for complicated diffuse arteriovenous malformations.@*Methods@#From Dec. 2014 to Dec. 2016, 12 cases with complicated diffuse arterioveneous malformations were treated by RFA in our hospital. The clinical records were retrospectively reviewed. The lesion size ranged from 10 cm×7 cm to 28 cm×30 cm. Ablation procedures with " high power and long time" technique were performed under real time color Doppler monitoring. The impedance model were used and ablation needles were punctured into core lesions with the most abundant blood flow. Power was set as 90 to 110 W for central core lesions, and 60 to 80 W for superficial or surrounding lesions. The average ablation time was from 60 to 90 min (average, 75 min). Next treatment would be performed 3 months later when neccessary. The therapeutic efficacy was evaluated on a 4-level scale.@*Results@#Hyperpyrexia occurred in 1 patients during first and second treatments. Transient postoperative hemoglobinuria occurred in 2 patient. Full thickness defects induced by tissue necrosis in the original ulcer area of cheek occurred in 1 patient, which was reconstructed with pedicle Trapezius muscle myocutaneous flap. Bleeding symptom in 7 cases stopped after only 1 treatment. After a follow-up period of 1-3 years, the efficacy was graded as Ⅳ in 8 case, as Ⅲ in 4 cases.@*Conclusions@#For complicated diffuse arteriovenous malformations, radio frequency ablation with "high power and long time" technique under real time color Doppler monitoring can completely damage the deep core soft lesions, and control the life-threatening hemorrhage effectively, which can be recommended as the alternative therapy when surgery, interventional embolizationor or sclerosant injection can not control the lesions.
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Objective To retrospectively analyze the therapeutic effect of endoscopic ablation combined with metal stent implantationon biliary obstruction caused by unrespectable cholangiocarcinoma. Methods Fourty-seven patients with unrespectable cholangiocarcinoma were enrolled in this study ,who were treated in our department from June 2013 to June 2016. Patients in the experimental group(n = 24)underwent ERCP combined with metal stent implantation for biliary tract ablation. Patients inthe control group(n=23)underwent ERCP with simple metal stent implantation. Liver function indicators,complications,patency rate and survival rate were analyzed between the two groups. Results A total of 51 patients were satisfactorily performed the operation of metal stent implantation. One week after operation,the levels of total bilirubin(TBIL),alkaline phosphatase(ALP),gamma-glu-tamyltransferase(GGT)and alanine aminotransferase(AST)in the experimental group were much lower than those in the control group(P<0.05,respectively). After 3-month follow-up,the patency rate in the experimental group was significantly greater than that in the control group(P<0.05). The patency and survival time of patients in the experimental group were significantly higher than thosein the control group ,with 8.56 ± 1.12 vs 5.73 ± 0.81 months and 13.88±1.45 vs 9.48±1.38 months,respectively(P<0.05). No postoperative bleeding,perforation and other se-rious complications were found in all cases,8 patients with postoperative biliary tract infection and the increased blood amylase received anti-infective treatments,such as inhibition of symptomatic improvement after treatment. Conclusion The results of endoscopic radiofrequency ablation combined with metal stent implantation for the treatment of unrespectable cholangiocarcinoma were significantly better than those of simple metal stent implantation.
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Atrial Fibrillation(AF) and its complications are serious threat to human health and the radio frequency ablation (RFA) becomes one of the main therapies of AF. Conventionally, the RFA is performed by unipolar ablation mode. Because the unipolar ablation mode is point-to-point and incomplete linear lesion formation, the success rates of treatment on AF decline and the procedures are time consuming. In order to solve these shortcomings, the bipolar ablation mode and the multichannel frequency ablation method that facilitate the easy creation of linear lesion are presented, especially kinds of multichannel frequency ablation technique and applications are introduced in this paper.
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Objective@#To investigate the prognostic factors of primary liver cancer treated with transcatheter arterial chemoembolization (TACE) combined with radiofrequency ablation (RFA), and then to establish a prognostic model.@*Methods@#Clinicopathological and follow-up data of 145 patients who underwent TACE combined with RFA from January 2010 to December 2012 were retrospectively analyzed. Univariate and multivariate survival analyses were performed using the Cox proportional hazards model, and the prognostic model was established.@*Results@#The 1, 2, and 3-year survival rates were 92.6%, 81.4% and 66.2%, respectively. The 3-year recurrence and metastasis rate was 64.8%.Multivariate analysis showed that female cases and higher serum albumin levels were the protective factors for the 3-year overall and relapse-free survival of patients(P<0.05 for all). High levels of alpha-fetoprotein (AFP), alanine aminotransferase (ALT), total bilirubin (TBIL), portal vein thrombosis and higher Child Pugh stages were the independent risk factors for the 3-year overall survival(P<0.05 for all). High levels of AFP, TBIL, portal vein thrombosis and advanced stages of BCLC staging (B and C) were the independent risk factors for tumor recurrence and metastasis(P<0.05 for all). The predictive model established based on the multivariate analysis showed good sensitivity and specificity. The area under ROC curve were higher than 0.90.@*Conclusions@#The prognosis of liver cancer patients treated with TACE combined with RFA is affected by various clinicopathological factors. The systematic evaluation of the relevant factors before treatment may help to select proper patients and improve prognosis.
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Objective To investigate the value of real-time elastography (RTE) in evaluating the characteristics and elasticity index (E-index) changes at different echo level of uterine fibroids before and after radiofrequency ablation (RFA).Methods A total of 43 patients (with 55 lesions) accepted RFA under ultrasound guidance in the Fourth Affiliated Hospital of Harbin Medical University from September 2013 to January 2015.All lesions were confirmed to have no perfusion through ultrasonography 1 h after RFA.The diameter of lesions ranging from 1.0 cm to 3.0 cm (with an average of 1.9± 1.2 cm).Preoperative lesions were classified into 3 groups for comparison based on ultrasonic echo type,group A:hypo echo (n=30);group B:hyper echo (n=12);and group C:mixed echo (n=12).Measured elasticity index E-index and internal uniformity (△ E) were analyzed.Comparisons of E value and△ E value were performed with repeated measures.RTE images features using x2 test of Fisher inspection comparison at the same time differences between groups.Results (1) Before RFA,RTE images showed blue alternating with green with green being dominated accounting for 70％ (21/30).50％ of RTE images in group B were completely covered in blue (6/12),while group C exhibited 53.9％ blue alternating with green with blue being dominated (7/13).There were statistically significant characteristics of RTE images among 3 groups (P ＜ 0.01).1 h after RFA,74.5％ lesions exhibited with blue being dominated (41/55).However,83.6％ (41/55) exhibited with blue 3 months after RFA.The difference in characteristics of RTE among 3 groups displayed no statistical significance (P ＞ 0.05).(2) The comparison of E-index revealed that before RFA,the E value was the lowest in the group A and the highest in the group B,while the group C was between them.There was significant difference between group A and B (F=19.25,P ＜ 0.01).E-index elevated in all the three groups and significant differences were found 1 h,3 month after RFA in comparison with that before RFA in the group A (F=386.75,294.68,both P ＜ 0.01).In addition,significant differences were also found 1 h,3 month after RFA in comparison with the treatment in the group B (F=29.98,45.88,both P ＜ 0.01).As for the group C,there were significant differences in E-index 1 h,3 month after RFA compared with before RFA (F=120.29,139.64,both P ＜ 0.01).3 months after RFA,E-index further elevated in the three groups and no significant inter-group difference was found at the same time points (P ＞ 0.05).(3)Before RFA,the△ E value was lower in group A and group B,while higher in the group C,group C presenting significant difference from group A and B (F=484.68,344.15,both P ＜ 0.01).At 1 h after RFA,△ E value was higher in group A and group C,while lower in group B,with group B showing significant difference from the low and mixed echo groups (F=53.58,94.79,both P ＜ 0.01).Significant difference was observed 1 h after surgery compared to before RFA in group A (F=154.35,P ＜ 0.01).Significant difference was also found 1 h after RFA compared to 3 month after RFA in group A (F=266.85,P ＜ 0.01).As for group C,there were also significant differences in△ E-index before treatment and 1 h after RFA compared with 3 month after RFA (F=103.24,76.53,both P ＜ 0.01).At 3 months after RFA,△ E-index decreased in all three groups.No significant inter-group difference was found at the same time points (all P ＞ 0.05).Conclusions RTE characteristics and the elasticity index are distinctly different among uterine fibroid at various echo intensities.RTE contributes to judging changes in hardness before and after RFA.The application of RTE for quantitative comparison of lesion hardness and uniformity can be served as the foundation for evaluating therapeutic effects of RFA.
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Objective To evaluate the changes of left atrial structure and function in the patients with atrial fibrillation who accepted bi -polar radio frequency current ablation .Methods All patients in our study were divided into three groups including the ones who had accept -ed bipolar radio frequency current ablation because of atrial fibrillation ,the ones who refused to accept ablation operation in despite of atrial fibrillation and the ones who maintained sinus rhythm before operation .All patients accepted TTE before and after operation .Results The rate of transverse diameter change of ablation group (24.24 ±8.67)%was larger than those of other two groups (P<0.05).Left atrial chan-nel capacity volume change rate of ablation group (17.18 ±3.26)%were larger than the values of the group who were suffering atrial fibrilla-tion but refused ablation advice (0.86 ±0.26)(P<0.05).Left atrial total ejection fractions of ablation group (202.41 ±81.59)%were lar-ger than the values of the group who were suffering atrial fibrillation but refused ablation advice (109.53 ±60.91)%( P<0.05) .And its ac-tive ejection fractions(12.18 ±3.48)%,total ejection fractions(41.31 ±8.26)%and so forth were less than the group who maintained si-nus rhythm before operation(21.33 ±5.61)%,(45.05 ±7.37)%,respectively (P<0.05).Left atrial posterior wall center and cardiac basal segment strain(14.34 ±9.47)%,(13.20 ±8.38)%,respectively,and strain rate values after operation of ablation group were less than other segments .Conclusion Left atrial structure remodeling inversion was not obviously 3~6 months after bipolar radio frequency cur-rent ablation .And at the same time ,the improvement of left atrial storage function was not obviously compared with the group who refused ab -lation advice,left atrial channel function compensation degree descended obviously left atrial co -pumping function in ablation group increased obviously,left atrial posterior wall center and cardiac basal segment systolic and distolic function were less than other segments of left .
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Objective To investigate the feasibility of our new found 3-dimensional contrast-enhanced ultrasound 3D-CEUS registration system as an early assessment of the therapeutic response to radio frequency ablation for liver cancer Methods Twenty-seven patients with 28 lesions accepted 3D-CEUS before and after radio frequency ablation RFA the therapeutic respond to which would be assessed with 3D-CEUS registration system recording the rate of successful registration The CT was considered as the reference standard Results Ten cases 35 7% were successful matched with auto-registration and 24 cases 85 7% were succesful matched with interactive-registration relatively All cases were considered as complete ablated which were confirmed by CECT with 100% accuracy There were two cases achieving ablation margins ≥5 mm without local tumor progression LTP and nineteen cases achieving 0 -4 mm ablation margin with 3 LTP 3-month 6-month and 1-year later Conclusions The 3D-CEUS interactive-registration system can easily assess the therapeutic response of RFA in liver cancer immediately with high accuracy.
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Objective To evaluate the feasibility and therapeutic efficacy of real-time virtual navigation system (RVS) combined with contrast-enhanced ultrasonography (CEUS) for hepatocellular carcinoma undetectable by conventional ultrasound and CEUS.Methods A total of 213 patients with 265 lesions (undetectable on conventional ultrasound but detectable by other imaging examinations) were enrolled in this study.CEUS was performed,and lesions which were detected with CEUS were given CEUS guided radio-frequency ablation (RFA) (CEUS group).RVS combined with CEUS was performed to locate the rest lesions and guide RFA (RVS + CEUS group).Diagnostic value and therapeutic efficacy of RVS + CEUS were assessed.Results In 256 lesions,174 (65.7％) could be detected with CEUS,and among the rest 91 lesions,82 (90.1％) lesions could be detected by RVS combined with CEUS.The technique effectiveness rate of RVS + CEUS was significantly higher than that of CEUS (x2 =18.85,P ＜0.0001).Complete ablation rate after one month in RVS+ CEUS group was 9t.5％ (75/82),which was significantly higher than that in CEUS group [86.2％ (150/174),P ＜0.05].Local progression in one year in CEUS group and RVS + CEUS group were 13.4％ and 10.9％,respectively.Conclusions RVS combined with CEUS is feasible for hepatocellular carcinoma undetectable by conventional ultrasonography and CEUS,and the therapeutic efficacy of RVS + CEUS guided RFA is satisfactory.
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Objective:To research on the radio frequency ablation (RFA) combined with the clinical effect of chemotherapy in patients with advanced non small cell lung cancer and lung metastasis. Methods:From 2011 May to 2012 in our hospital 06 months 60 cases of metastatic non-small cell lung cancer and lung cancer patients, divided into radio frequency ablation(RFA) combined with chemotherapy group of 30 cases and a simple chemotherapy group 30 cases, referred to as the treatment group and the control group. To observe the change of tumor volume in patients with poor survival rate, years, tumor recurrence rate, and postoperative complications. Results:Three months after treatment in treatment group tumor recession(CR) in 5 cases(16.7%), part of the recession(PRa) 18(60%), partial mild recession(PRb) 6(20%), no degradation(NR), 1(3.3%), tumor size change significantly better than the control group. The treatment group patients 12 months survival rate was 86.7%, higher than that of the control group(70%). The treatment group of 12 months of tumor recurrence rate of 6.7%, lower than that of the control group(26.7%). No obvious adverse complications of the treatment group of 30 patients after operation. Conclusion:Radiofrequency hyperthermia ablation combined with chemotherapy in treatment of advanced non small cell lung cancer and metastatic lung cancer clinical effect is obvious.
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Objective To assess the efficacy of radiofrequency therapy combined with ozone injection in the treatment of lumbar disc protrusion. Methods A total of 202 patients with lumbar disk protrusion were included and divided into three groups:radiofrequency (RF) group, ozone (Oz) group, and combination (Co) group. The efficacy was evaluated by visual analogue scale (VAS), Macnab curative effect evaluation, and oswestry disability index (ODI) at 1d, 1m and 6m after treat?ment. Results There were no significant differences in gender, age, the course of disease, preoperative VAS scores and ODI scores (P>0.05). All patients were operated successfully. There were no infection of the intervertebral disc, no compli?cations of spinal cord, nerve and no blood vessel injury. There were no significant differences in preoperative VAS and ODI scores between three groups. The VAS and ODI scores were significantly lower at 6 month and 12 month after operation in Co group combined with those of RF group and Oz group. There were no significant differences in these two scores between RF group and Oz group (P>0.05). There were no significant differences in effective rates at 1d, 6 month and 12 month after operation between three groups (P>0.05). But the excellent and good effective rates were higher in Co group than those of RF and Oz groups. There were no significant differences in excellent and good effective rates between RF group and Oz group. Conclusion The therapy of radiofrequency combined with ozone injection is an efficient and mini-invasive tech?nique for the treatment of lumbar disc protrusion and worth promoting.
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Objective Explore a new treatment by orthogonal design of no empty cases :treatment of knee osteoarthritis by nerve locator ,for knee joint peripheral nerve branch implement selective radio frequency ablation .Methods According to patients′age ,body mass index ,gender ,organs ,in the course of the disease ,preoperative VAS score ,first divided into nine groups ,each group of four people ,then randomly assigned to four groups and each group 9 cases ,a total of 36 people .With nerve locator ,design of 4 factors and 3 levels ,no empty cases of orthogonal design ,every time 9 people by radio frequency ablation treatment of knee joint pe-ripheral nerve .Repeat 4 times to reduce the sampling error ,obtain the VAS difference between postoperative 1 week and preopera-tive .Results The best combination of treat knee joint osteoarthritis by Radio frequency ablation was A3B3C(1-3)D(1-3) .Selective radio frequency ablation knee peripheral nerve branch target rf temperature is 90 ℃ ,120 seconds ,lidocaine concentration(0 .5% to 2% ) and lidocaine measurement (0 .5 to 1 .5 mL) .Conclusion Using the orthogonal design of no empty cases ,for knee joint pe-ripheral nerve branch for selective radio frequency ablation by nerve locator .Treatment of knee joint osteoarthritis in A3B3C(1-3) D (1-3) combination effect exact ,minimally invasive ,safe ,accurate location ,the treatment effect is good ,low cost ,simple and high ef-ficiency .
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Objective To investigate the nursing risks in the patients undergoing radio-frequency ablation surgery during cardiac valve replacement.Methods The nursing risks in 110 patients undergoing radio-frequency ablation surgery during cardiac valve replacement were summarized to include disorder of water electrolyte and acid-base balance, arrhythmia,hypothermia,skin ulcer,reduction of effective circulating blood volume,infection and so on, so as to carry out the corresponding nursing measures. Results Ventricular fibrillation occurred in 11 patients,hypothermia after rewarming on cardiopulmonary bypass in 31 patients,left atrial bleeding after aortic de-clamping in 1 patient.All the complications were successfully controlled by corresponding management. The operation time ranged from 178 mins to 310 mins and average time was(245.32±34.40)mins.Conclusion The full-scale assessments and effective nursing interventions are the key points to improve the efficiency and success of cardiac valve replacement combined with radio-frequency ablation.
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Objective To compare the clinical effects of surgical treatment and ultrasonic guidance percutaneous radiofrequency ablation(PRFA) therapy in the treatment of liver cancer.Methods 78 patiens with live cancer were randomly divided into the operation group and PRFA group,each group had 39 patients.The operation group was treated with traditional open surgery,the PRFA group was treated with radiofrequency ablation.The clinical effect was compared between the two groups.Results All patients were followed up after therapy,the 1,2,3-year survival rate between operation group and PRFA group had no significant differences (all P ＞ 0.05),but in the patients whose tumor were central type and samller than 3cm,the 1,2,3-year survival rate of PRFA group were significantly higher than operation group(x2 =4.819,4.815,4.919,all P ＜ 0.05).Conclusion Ultrasonic guidance percutaneous radiofrequency ablation therapy in the treatment of liver tumor is effective,and the effect is better than operation group,especially for the patients with central type tumor and the tumor samller than 3cm.
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Background : This study was conducted to compare the conventional retrograde arterial approach (RAA) with the transeptal approach (TSA) for radiofrequency catheter ablation (RFA) of left accessory pathways (AP). Materials and Methods: Sixty consecutive patients (44 male; mean age of 35.60 ± 11.63 years) with 60 left APs (39 overt and 21 concealed) underwent catheter ablation using the TS method (30 patients) and the RA method (30 patients) in an alternate fashion. The analysis was performed according to the intention-to-treat principle. Results : The transeptal puncture was successfully performed in 29 patients (96%). This access allowed primary success in the ablation in all the patients without any complication. When we compared this approach with the RAA there was no difference as regards the primary success (p = 0.103), fluoroscopy time (p = 0.565) and total time (p = 0.1917). Three patient in the RAA group presented a vascular complication. The TSA allowed shorter ablation times (p=0.006) and smaller number of radiofrequency applications (p = 0.042) as compared to the conventional RAA. The patients who had unsuccessful ablation in the first session in each approach underwent with the opposite technique (cross-over), with a final ablation success rate of 100%. Conclusion : The TS and RA approaches showed similar efficacy and safety for the ablation of left accessory pathways. The TSA allowed shorter ablation times and smaller number of radiofrequency applications. When the techniques were used in a complementary fashion, they increased the final efficacy of the ablation.
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Objective To observe the changes and clinical significances of ischemia modified albumin (IMA),cardiac triponin T (cTnT) and creatine kinase MB (CK-MB) in transient myocardial ischemia induced by radio frequency ablation ( RFA ) in patients with arrhythmia.Methods One hundred and twelve patients with arrhythmia undergoing RFA and 91 patients undergoing CAG were evaluated with blood levels of IMA,cTnT and CK-MB before and 3 and 6 hours after operation.Results Serum levels of IMA at 3 h [ (80.62 ± 7.53 )U/ml ] and 6 h [ (76.37 ± 9.21 ) U/ml ] after operation rose significantly (P ＜ 0.05 ) in the 112 cases of RFA compared with the preoperative [ ( 45.42 ± 7.00 ) U/ml ].While the levels of IMA were not significantly different at 3 and 6 hours after CAG in the 91 patients compared with before sugery ( P ＞ 0.05).The levels of cTnT and CK-MB remained unchanged between the two groups after the procedures ( P ＞ 0.05 ).Conclusion The levels of IMA were quickly increased after myocardial ischemia induced by RFA and this change occurred earlier than that of cTnT.IMA is an early diagnostic biochemical marker of myocardial ischemia.